Come join the largest public hospital system in the nation! Every day, we work together to make an extraordinary difference in the health and well-being of each individual we serve without exception. Join our team and help us create a positive patient experience.
NYC Health + Hospitals provides essential inpatient, outpatient, and home-based services to more than one million New Yorkers every year in more than 70 locations across the city’s five boroughs.
The Quality Management Clinical Lead (Associate Director) is responsible for extracting clinical and quality insights from medical records to improve the quality of care delivered to patients receiving care at primary care clinics participating in the NYC H+H ACO.
• Responsible for reviewing medical records, and abstracting clinical data elements for quality measures aligned with ACO contractual criteria.
• Use system derived data to identify and intervene prospectively for potential quality gaps, process variation, unwarranted use patterns
• Supports CMO in clinical analyses of ACO patient population, with particular focus on in-depth understanding of high utilizer and vulnerable patients, their points of encounter with health care system and barriers to engagement with care
• Monitors response to hospital admissions and emergency department presentations for ACO patients
• Enters quality measure data into appropriate quality databases and interfaces to facilitate reporting.
• Responsible for learning/maintaining current knowledge of ACO quality program requirements.
• Participates in ACO performance improvement initiatives as it relates to quality measures.
• Serves as a quality improvement advisor within the ACO department to coordinate and guide useful workflows, data capture and reporting.
• Contributes to business requirement development for standardized reports focused on the successful delivery of ACO outcomes measures. Considers data derived from the electronic health report (EHR), ACO generated reports (commercial, direct to employer or government).
• Communicates with ACO quality teams to support understanding and reporting of performance improvement activities.
• Completes electronic health record (EHR) / chart review, data entry, quality measure order entry, scanning results and other reporting requirements by deadlines as stipulated by the regulatory agency and/or ACO Leadership.
• Provides guidance in the development of electronic workflow build to support quality measure compliance/abstraction as appropriate.
• Assists with developing communication materials to educate care teams on program requirements, workflow, and other elements as it relates to the quality program
• RN/LPN license in the state of NY
• Minimum of 5-7 years clinical experience required.
• Must have knowledge of practitioner care principles, procedures, and practices.
• Demonstrates understanding of Hospital and Ambulatory/Practice-Based clinical environments and workflows.
• Experience in working with an Electronic Health Record.
• Proficiency in database, spreadsheet, and word processing software applications essential. Microsoft Office, excel proficiency required.
• Familiar with NCQA, CMS, IHA, HEDIS, AHRQ resources and quality measures, PDCA and/or other performance improvement methodologies
• Demonstrates the ability to effectively communicate with all levels of hospital and practice-based staff in a verbal and written manner
• Possesses keen analytical skills and demonstrates the ability to be very organized.
• Effectively plan projects, workflow activities, and assignments.
• Performance Improvement and Quality Management experience preferred.
• Prior experience in clinical quality measure data abstraction preferred.
• Some travel to other H+H ACO network facilities/practices may be require
• Master’s Degree in Art or Science with a specialization in Hospital Administration, Health Care Administration, Administrative Medicine or in Public Health when conferred for a program in hospital administration from an approved college or university; and,
• Four years of administrative experience and background at responsible management and administrative levels; or,
• An equivalent combination of training, educational background and experience in related fields and educational disciplines; and,
• Knowledge of fundamentals of hospital organization, administration and standards, regulations and laws applicable to hospital operations. Knowledge of principles of business and personnel administration, management functions and support service functions and ability to direct and supervise personnel.
We offer a competitive benefits package that includes health benefits, retirement and pension plans, paid time off, professional development, and an employee perks program. To see a detailed job description, please visit employment.nychhc.org and search for job # 36496.
We are an Equal Opportunity Employer M/F/D/V